Unintentional firearm death across the urban-rural landscape in the United States.

TitleUnintentional firearm death across the urban-rural landscape in the United States.
Publication TypeJournal Article
Year of Publication2012
AuthorsCarr BG, Nance ML, Branas CC, Wolff CS, Kallan MJ, Myers SR, Wiebe DJ
JournalJ Trauma Acute Care Surg
Date Published2012 Oct
KeywordsAccidents, Adult, Cross-Sectional Studies, Death Certificates, Female, Firearms, Follow-Up Studies, Homicide, Humans, Male, Middle Aged, Retrospective Studies, Rural Population, Suicide, United States, Urban Population, Wounds, Gunshot

BACKGROUND: Unintentional injuries are one of the leading causes of death in the United States. Many of these injuries are preventable, and unintentional firearm injuries, in particular, may be responsive to prevention efforts. We investigated the relationship between unintentional firearm death and urbanicity among adults.

METHODS: This study was a retrospective analysis of national death certificate data. Unintentional adult firearm deaths in the United States from 1999 to 2006 were identified using the Multiple Cause of Death Data files from the National Center for Health Statistics. Decedents were assigned to a county of death and classified along an urban-rural continuum defined by population density and proximity to metropolitan areas. Total unintentional firearm death rates by county were analyzed in adjusted analyses using negative binomial regression.

RESULTS: A total of 4,595 unintentional firearm injury deaths of adults occurred in the United States during the study period (a mean of 574.4 per year). Adjusted rates of unintentional firearm death showed increases from urban to rural counties. Americans in the most rural counties were significantly more likely to die of unintentional firearm deaths than those in the most urban counties (relative rate, 2.16; 95% confidence interval, 1.44-3.21, p = 0.002).

CONCLUSION: Rates of unintentional firearm death are significantly higher in rural counties than in urban counties. Prevention strategies should be tailored to account for both geographic location and manner of firearm injury.

LEVEL OF EVIDENCE: Epidemiologic study, level III.

Alternate JournalJ Trauma Acute Care Surg
PubMed ID22976424
Grant ListF32HS018604-01 / HS / AHRQ HHS / United States
K02AA017974 / AA / NIAAA NIH HHS / United States
R01CE001615 / CE / NCIPC CDC HHS / United States